Prep U Med Surg Musculoskeletal

The nurse is caring for a patient with a bone tumor. The nurse provides education that teaches the patient to implement measures to reduce the risk of pathologic fractures. What intervention will assist the patient in fracture prevention?

Supporting the affected extremity with external supports (splints)

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

A client is recovering from a fractured hip. The nurse would suggest that the client increase intake of which of the following to facilitate calcium absorption from food and supplements?

Vitamin D

A patient diagnosed with carpal tunnel syndrome (CTS) asks the nurse about numbness in the fingers and pain in the wrist. In responding to the patient, how would the nurse best describe CTS?

"CTS is a neuropathy that is characterized by compression of the median nerve at the wrist."

The nurse is conducting the admission assessment for the 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.

A nurse is teaching a client who was recently diagnosed with carpal tunnel syndrome. Which statement should the nurse include?

"Ergonomic changes can be incorporated into your workday to reduce stress on your wrist."

The nurse is educating a group of women on the prevention of osteoporosis. The nurse recognizes the education as being effective when the group members make which statement?

"We need an adequate amount of exposure to sunshine."

The older client asks the nurse how best to maintain strong bones. The best response by the nurse is:

"Weight-bearing exercises can strengthen bones."

The nurse is preparing the client for computed tomography. Which information should be given by the nurse?

"You must remain very still during the procedure."

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

A small-framed, thin 45-year-old white woman

A client is admitted with acute osteomyelitis that developed after an open fracture of the right femur. When planning this client's care, the nurse should anticipate which measure?

Administering large doses of I.V. antibiotics as ordered

The nurse is providing care to a client following a knee arthroscopy. Which of the following would the nurse expect to include in the client's plan of care?

Administering the prescribed analgesic.

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

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 electromyography

An appropriate nursing intervention for the client following electromyography is to:

Apply warm compresses.

Which of the following diagnostic studies are done to relieve joint pain due to effusion?

Arthrocentesis

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

A middle-aged woman sustained an elbow fracture in a bicycle crash and has required reduction and fixation to aid healing. The nurse is aware of the need for vigilant neurovascular assessment. How should the nurse assess the function of the patient's ulnar nerve?

Ask the patient to spread her fingers as widely as possible.

Which medication taken by the client in the previous 24 hours would be of greatest concern to the nurse caring for a client undergoing a bone biopsy?

Aspirin

A nurse is caring for an elderly female client with osteoporosis. When teaching the client, the nurse should include information about which major complication?

Bone Fracture

A patient tells the physician about shoulder pain that is present even without any strenuous movement. The physician identifies a sac filled with synovial fluid. What condition should the nurse educate the patient about?

Bursitis

Which hormone inhibits bone reabsorption and increases calcium deposit in the bone?

Calcitonin

Which of the following inhibits bone resorption and promotes bone formation?

Calcitonin

The nurse is preparing an education program on risk factors for musculoskeletal disorders. Which of the following would be inappropriate risk factor for the nurse to include in the teaching program?

Calcium-rich diet

A female patient tells the nurse that she has pain and numbness to her thumb, first, and second finger of her right hand. The nurse discovers that the patient is employed as an auto mechanic, and that the pain is increased while working. This may indicate that the patient could possibly have what?

Carpal Tunnel Syndrome

Which group is at the greatest risk for osteoporosis?

Caucasian women

The nurse is caring for a client who was involved in an automobile accident and sustained multiple trauma. The client has a Volkmann's contracture to the right hand. What objective data does the nurse document related to this finding?

Clawlike deformity of the right hand without ability to extend fingers

What is the term for a rhythmic contraction of a muscle?

Clonus

A client is admitted to the emergency room after being hit by a car while riding a bicycle. The client sustained a fracture of the left femur, and the bone is protruding through the skin. What type of fracture does the nurse recognize requires emergency intervention?

Compound

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. The nurse understands that this type of fracture is significant because:

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

Choose the correct statement about the endosteum, a significant component of the skeletal system:

Covers the marrow cavity of long bones

Which of the following clinical manifestations would the nurse expect to find in a client who has had osteoporosis for several years?

Decreased height

Which general nursing measure is used for a client with a fracture reduction?

Encourage participation in ADLs

Which term refers to a fracture in which one side of a bone is broken and the other side is bent?

Greenstick

A nurse practitioner who works with many older adult patients integrates screening for osteoporosis into health promotion activities. What screening tool is most clinically useful when screening for osteoporosis?

Hip bone mineral density (BMD) testing

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

Increased diameter of the calf

The nurse is caring for a patient who sustained an open fracture of the right femur in an automobile accident. What does the nurse understand is the most serious complication of an open fracture?

Infection

A child has fallen off a swing on a playground and sustained a greenstick (partial) fracture of his radius. Because the child is otherwise healthy, healing has begun promptly after his injury. Which of the following is the first stage of bone healing?

Inflammation and hematoma formation

A female client is at risk for developing osteoporosis. Which action will reduce the client's risk?

Initiating weight-bearing exercise routines

Which of the following techniques will the nurse implement to assess a patient's gait?

Instruct the patient to walk away from the nurse for a short distance.

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.

The nurse is preparing a patient for discharge from the emergency room to home after the patient incurred a sprain to the left ankle. While providing discharge teaching, the nurse should instruct the patient to do what?

Keep an elastic compression bandage on the ankle.

A 67-year-old woman with a history of osteoarthritis has been admitted to the postsurgical unit from the PACU following a bunionectomy. Which of the following nursing actions should the nurse integrate into this patient's immediate care?

Keep the patient's foot elevated above the level of her heart.

A client undergoes hip-pinning surgery to treat an intertrochanteric fracture of the right hip. The nurse should include which intervention in the postoperative care plan?

Keeping a pillow between the client's legs at all times

Which of the following is an example of a hinge joint?

Knee

A client is brought to the emergency department after injuring his right arm in a bicycle accident. The orthopedic surgeon tells the nurse that the client has a greenstick fracture of the arm. What does this mean?

One side of the bone is broken and the other side is bent

Which serum level indicates the rate of bone turnover?

Osteocalcin

A 49-year-old man with a history of poorly controlled type 1 diabetes has developed osteomyelitis adjacent to a chronic diabetic ulcer on his great toe. The patient has been informed that medical treatment for osteomyelitis requires a longer course of antibiotics than most other infections because:

Osteomyelitis involves the active infection of bone tissue, which is largely avascular.

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

A client who has injured a hip in a fall cannot place weight on the leg and is in significant pain. After radiographs indicate intact yet malpositioned bones, what repair would the physician to perform?

joint manipulation and immobilization

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

A client has been diagnosed with a muscle strain. What does the physician mean with the term "strain"?

stretched or pulled beyond its capacity

The client has just been diagnosed with osteomyelitis. Osteomyelitis is an infection of the bone, resulting in limited blood supply to the bone, inflammation of and pressure on the tissue, bone necrosis, and formation of new bone around devitalized bone tissue. What are possible causes of osteomyelitis? Select all that apply.

-Trauma, such as penetrating wounds or compound fractures -Vascular insufficiency in clients with diabetes or peripheral vascular disease -Surgical contamination, such as pin sites of skeletal traction

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. After surgery, the nurse implements measures to prevent complications. Which complications is the nurse seeking to prevent? Select all that apply.

-Wound infection -Skin breakdown -Pneumonia

An 82-year-old woman was diagnosed with osteoporosis several years and has lost more than 5 inches in height over the past several years as a result of structural changes in her vertebrae. The nurse should recognize that this woman is experiencing the effects of:

A compression fracture

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and she observes petechiae on the client's chest. Which nursing action is indicated first?

Administer oxygen

An x-ray demonstrates a fracture in which a bone has splintered into several pieces. Which type of fracture is this?

Comminuted

A client has had surgical repair of a hip injury after joint manipulation was unsuccessful. During postoperative recovery, what specific complication might develop in this client's case?

Compartment Syndrome

A client sustains a fractured right humerus in an automobile accident. The arm is edematous, the client states that he cannot feel or move his fingers, and the nurse does not feel a pulse. What condition should the nurse be concerned about that requires emergency measures?

Compartment syndrome

Two days after application of a cast to treat a fractured femur, the patient tells the orthopedic health care provider that he is experiencing severe, deep, and constant pain in his leg. The nurse suspects a diagnosis of:

Compartment syndrome

A client comes to the Emergency Department complaining of localized pain and swelling of his lower leg. Ecchymotic areas are noted. History reveals that the client got hit in the leg with a baseball bat. Which of the following would the nurse suspect as most likely?

Contusion

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?

Diaphyses

Which of the following would lead a nurse to suspect that a client has a rotator cuff tear?

Difficulty lying on affected side

A client who suffers an injury in a local high school hockey game presents with left shoulder pain. The client cannot move the left arm, and the left shoulder is lower than the right shoulder. The nurse recognizes the client most likely has a:

Dislocated shoulder

A client with a fracture develops compartment syndrome that requires surgical intervention. The nurse would most likely prepare the client for which of the following?

Fasciotomy

A patient sustained an open fracture of the femur 24 hours ago. While assessing the patient, the nurse observes the patient is having difficulty breathing, and oxygen saturation decreases to 88% from a previous 99%. What does the nurse understand is likely occurring with this patient?

Fat emboli

A 42-year-old man presents at the clinic complaining of pain in his heel so bad it inhibits his ability to walk. The patient is diagnosed with plantar fasciitis. Patient teaching provided by the nurse would include what instructions to decrease the pain associated with this condition?

Gently stretching the foot and the Achilles tendon

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

Which of the following is the most common site of joint effusion?

Knee

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?

Kyphosis

Which of the following is an age-related change to the musculoskeletal system?

Loss of bone mass

The nurse is employed at a long-term care facility caring for geriatric clients. Which assessment finding is characteristic of an age-related change?

Loss of height

Which nursing intervention is appropriate for minimizing muscle spasms in the client with a hip fracture?

Maintain Buck's traction

A patient comes to the clinic and informs the nurse of numbness, tingling, and a burning sensation in the arm from the elbow down to the fingers. What type of symptom would this be documented as?

Paresthesia

A nurse is taking a newly admitted patient's health history, and the patient states that she has had ongoing problems with a "pinched nerve." In addition to the potential for pain, the nurse should consider the fact that physical pressure that is placed on nerves can often lead to what?

Paresthesias

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.

The nurse is educating a client with low back pain on proper lifting techniques. The nurse recognizes that the education was effective when the client

Places the load close to the body

Which intervention should the nurse implement when caring for the client who complains of phantom limb pain two months after amputation?

Reassure the client that phantom pain is common.

After a fracture, during which stage or phase of bone healing is devitalized tissue removed and new bone reorganized into its former structural arrangement?

Remodeling

During which stage or phase of bone healing after fracture does callus formation occur?

Reparative

Which of the following would be most important for the nurse to include in the teaching plan for a client who has undergone arthrography?

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

Which of the following is an appropriate priority nursing diagnosis for the client following an arthrocentesis?

Risk for infection

Which of the following deformities causes a lateral curving deviation of the spine?

Scoliosis

Which laboratory study indicates the rate of bone turnover?

Serum Osteocalcin

Which is a risk-lowering strategy for osteoporosis?

Smoking cessation

When assessing the client for scoliosis, the nurse:

Stands behind the client and asks the client to bend forward at the waist

A patient stepped on an acorn while walking barefoot in the backyard and developed an infection progressing to osteomyelitis. What microorganism does the nurse understand is most often the cause of the development of osteomyelitis?

Staphylococcus aureus

An adult is swinging a small child by the arms, and the child screams and grabs his left arm. It is determined in the emergency department that the radial head is partially dislocated. What is this partially dislocated radial head documented as?

Subluxation

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

Surgical debridement

Morton neuroma is exhibited by which clinical manifestation?

Swelling of the third (lateral) branch of the median plantar nerve

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

A nurse is teaching a female client about preventing osteoporosis. Which teaching point is correct?

The recommended daily allowance of calcium may be found in a wide variety of foods.

A 77-year-old man is recovering in the hospital after a recent femoral fracture and has rung his call light. The nurse has entered the room to find the patient in distress, clutching his chest while struggling to say, "I can't breathe." The nurse should take prompt action based on the knowledge that this patient may be experiencing what complication of lower extremity fractures?

Thromboembolism

A nurse advises a patient with a casted femur fracture to check for signs of a fat embolism. She tells the patient that the onset of symptoms for FES occur:

Within 12 to 48 hours

The nurse is reading the admission note for a client with a bone fracture that requires surgery. The note indicates the presence of crepitus. The nurse interprets this as being

a crackling sound

A has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications?

common adverse effects

Which of the following presents with an onset of heel pain with the first steps of the morning?

Plantar fasciitis

There are a variety of problems that can become complications after a fracture. Which is described as a condition that occurs from interruption of the blood supply to the fracture fragments after which the bone tissue dies, most commonly in the femoral head?

avascular necrosis