week 5 patho nclex
A nurse is caring for a client who twisted his ankle while running. Tests reveal damaged connective tissue that connects the movable bones of the joint. Based on this finding, the nurse prepares to teach the client about which anatomical structure that is injured? Tendons Ligaments Bursae Synovial joint
Ligament
Which of the following covers bones and has an inner layer that contains osteoprogenitor cells? Endosteum Periosteum Perichondrium Fibrocartilage
Periosteum
Magnetic resonance imaging of a client's knee has revealed the presence of bursitis. The nurse should anticipate performing which intervention for bursitis? Applying Buck's traction with 10-pound weights Obtaining a surgical permit to repair the bursae Administering an antihistamine like diphenhydramine to minimize inflammation Placing an ice pack on the knee to decrease swelling
Placing an ice pack on the knee to decrease swelling
Giant cell arteritis is a comorbid condition of: Systemic lupus erythematosus Polymyalgia rheumatica Pseudogout Gout
Polymyalgia rheumatica
The nurse assessing a client with scleroderma with CREST variant would include an assessment for: butterfly rash. thrombocytopenia. leukocytosis. Raynaud's phenomenon.
Raynaud's phenomenon.
Which intervention should the nurse recommend to best minimize the risk of nutritional rickets in an infant whose culture supports long-term breast-feeding without the introduction of foods? Select all that apply. Supplemental use of soy formula Regular exposure to sunlight Focused passive long bone exercise Vitamin D supplements
Regular exposure to sunlight Vitamin D supplements
A client with a compound fracture of the lower leg has a limb-lengthening system attached for stabilization. Which basic care activities can the nurse expect to provide? Select all that apply. Regular pin site care Isometric exercises Weight-bearing gait Bivalving the cast Neurovascular assessment
Regular pin site care Isometric exercises Neurovascular assessment
A young adult client who is a competitive skier complains of knee pain when climbing stairs or sitting with the knees bent. What will the nurse teach the client about the diagnosis of chondromalacia? The knee will require immobilization for about 6 weeks to heal from this injury. Rest and isometric exercises followed by ice are effective treatment measures. This is a lifelong inflammatory condition that should be treated with steroids. Strengthening exercises and a diet higher in calcium will heal the condition.
Rest and isometric exercises followed by ice are effective treatment measures.
When planning care for the client with severe osteoarthritis (OA) of the hip, the nurse includes which statement in a teaching session with the client? Select all that apply. "Avoid nonsteroidal anti-inflammatory medications." "A walker may be helpful to avoid excess pressure on your hips." "Try to balance your rest and exercise." "Using heat or cold to relieve pain may be helpful." "Losing weight or maintaining your ideal weight reduces stress on your joints."
"A walker may be helpful to avoid excess pressure on your hips." "Try to balance your rest and exercise." "Using heat or cold to relieve pain may be helpful." "Losing weight or maintaining your ideal weight reduces stress on your joints."
When administering a corticosteroid to a client with rheumatoid arthritis, a nurse includes which education about the medication? Select all that apply. "Corticosteroids do not prevent joint destruction." "Corticosteroids are taken for life to reduce inflammation." "Corticosteroids may be given to inhibit tumor necrosis factor." "Pain is relieved with use of corticosteroid medications." "These drugs are for short-term use."
"Corticosteroids do not prevent joint destruction." "Pain is relieved with use of corticosteroid medications." "These drugs are for short-term use."
A nurse is evaluating the progress of a client with chronic fatigue syndrome. Which statement by the client indicates successful symptom management? "I often find it is too much work to fix a meal." "My family wants me to volunteer at the animal shelter." "My schedule includes yoga and a weekly club meeting." "I work until I run out of energy, and then I rest."
"My schedule includes yoga and a weekly club meeting."
A client recently diagnosed with an injury to the articular cartilage of the knee asks the nurse how long it will take the injury to heal. Which statement is the best response from the nurse? "Loss of cartilage may never fully heal." "You will need to see an orthopedic specialist in order to determine how long healing will take." "Regeneration of most cartilage is slow. These injuries can take a long time to heal." "An injury to the articular cartilage will heal within 1 to 2 weeks."
"Regeneration of most cartilage is slow. These injuries can take a long time to heal."
A nurse is teaching a client diagnosed with osteoarthritis about the joint capsule. Which statement made by the client indicates that teaching was successful? "A moveable joint is called a synarthrosis." "The bursae are sac-like structures that sit between the articular cartilage surfaces." "The menisci are fibrocartilaginous structures that produce synovial fluid." "The synovial fluid in my joint capsule acts as a lubricant and helps the movement of the joint's articulating surfaces."
"The synovial fluid in my joint capsule acts as a lubricant and helps the movement of the joint's articulating surfaces."
The nurse determines that additional client education is needed when a client with gout makes which statement? "Increasing my intake of water each day will help stop the symptoms." "I will plan to eat more white meat rather than red meat." "I should avoid eating shellfish to decrease the risk of an episode." "When I have an exacerbation of my symptoms, a glass of red wine will be helpful."
"When I have an exacerbation of my symptoms, a glass of red wine will be helpful."
A child is suspected of having flexible "flat feet" based on a physical assessment. When explaining this condition to the parents, what would be the best explanation of the etiology?
"Your child's condition is a result of loose ligaments in the feet."
Regarding embryonic development, in what week do the paddle-shaped limb buds of the lower extremities begin to appear? 1st week 26th week 10th week 4th week
4th week
The nurse is reviewing the health histories of four clients. Select the client most at risk for developing secondary osteoporosis. A 42-year-old male with a healing leg fracture An 80-year-old male who resides in an assisted living facility A 22-year-old female taking oral contraceptives A 60-year-old female taking prednisone for asthma
A 60-year-old female taking prednisone for asthma
A child, diagnosed with juvenile idiopathic arthritis, should receive education about commonly prescribed medications. Which other priority aspect(s) of care should the nurse assess during regular clinic visits? Select all that apply. Pain and swelling in the first metatarsophalangeal in the joint Development of hip dysplasia Achieving growth and development milestones Appearance of calcifications at pressure points Nutiritonal status/issues
Achieving growth and development milestones Nutiritonal status/issues
In what anatomical areas are irregularly shaped bones located? Select all that apply. Ankles Rib cage Wrists Lower extremities Upper extremities
Ankles Wrists
Which chronic disorders have been associated with chronic fatigue? Select all that apply. Arthritis Anemia Cardiac disease Asthma Multiple sclerosis
Arthritis Anemia Cardiac disease Multiple sclerosis
The health care provider is evaluating a client who is at risk for the development of osteonecrosis. The client is at risk for: Aseptic necrosis of a bone segment caused by interruption of the blood supply Development of an unspecified mass or growth on the bone An acute infection of the bone An chronic infection of the bone
Aseptic necrosis of a bone segment caused by interruption of the blood supply
A nurse is floated to orthopedics to help with new admissions following a major accident on the highway. While caring for one client, the nurse notes a change in behavior, some disorientation, shortness of breath and tachycardia. Suspecting fat embolism, the priority for the health care provider should include which intervention(s)? Select all that apply. Begin oxygenation Page respiratory therapist to draw arterial blood gases Administer sedative medication to calm the client Suction the lungs to try to remove the fat emboli Administer corticosteroids stat
Begin oxygenation Page respiratory therapist to draw arterial blood gases Administer corticosteroids stat
What is the term use to describe a tumor that while growing slowly does not destroy the surrounding tissues? Malignant Ewing sarcoma Osteosarcoma Benign
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: High-impact aerobic exercise for 1 hour three times per week Running 1 mile per day with good athletic shoes Lawn bowling for 1 hour per week Brisk walking three times per week on a flat surface
Brisk walking three times per week on a flat surface
What are the closed sacs that are formed from the synovial membrane (but are not part of the joint) called? Ligaments Bursae Intra-articular menisci Tendons
Bursae
A client asks the nurse if drinking more milk will prevent the release of calcium from her bones. The best response by the nurse would be that the release of calcium from the bone into the extracellular fluid is regulated by: Parathyroid hormone Phosphate Calcitonin Vitamin D
Calcitonin
A nurse is caring for an adolesecnt female who is undergoing diagnostic studies for systemic lupus erythematosus (SLE). Which assessment findings does the nurse recognize as being consistent with childhood SLE? Select all that apply. Child has gained 20 lb (9.1 kg). Child is between 8 and 15 years of age. Child is of Asian descent. Child is fatigued and generally feels "under the weather." Child has increased serum creatinine.
Child is between 8 and 15 years of age. Child is fatigued and generally feels "under the weather." Child has increased serum creatinine.
The nurse is caring for several clients who have chronic fatigue. Which intervention is the appropriate match for the cause of the clients' fatigue? Clients with depression who are given a sedative Clients with insomnia who are served hot chocolate at bedtime Clients with end-stage renal disease receiving erythropoietin Clients with loss of muscle mass who are given analgesics
Clients with end-stage renal disease receiving erythropoietin
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 greenstick fracture Open spiral fracture Closed comminuted fracture Thromboemboli
Closed comminuted fracture
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: Fracture blisters Complex regional pain syndrome Thromboemboli Compartment syndrome
Compartment syndrome
Which type of materials are not included in a cancellous bone? Select all that apply. Densely calcified Soft Compact Cartilaginous
Densely calcified Compact Cartilaginous
A basketball player fell awkwardly, which resulted in a tear to the anterior cruciate ligament (ACL). The school nurses will anticipate the player to exhibit which clinical manifestations? Select all that apply. Abscess formation Large hematoma on the anterior knee surface Edema (swelling) of the knee Immovable (locked) knee joint Intense pain
Edema (swelling) of the knee Intense pain
Which diagnostic finding has been strongly linked to systematic lupus erythematosus (SLE)? Decreased rheumatoid factor Elevated anti-nuclear antibodies (ANA) Low red blood cell count An abnormal serum SLE assay
Elevayed anti-nuclear antibodies (ANA)
The nurse is assessing a client in early stage of rheumatoid arthritis. Which assessment findings would the nurse expect to find? Select all that apply. Erythema Warmth Tenderness Swelling Crepitus
Erythema Warmth Tenderness Swelling
Which symptoms are required for a diagnosis of psoriatic arthritis? Select all that apply. A prominent butterfly-shaped rash on the face Bone biopsy Evidence of nail changes Characteristic skin changes are evident
Evidence of nail changes Characteristic skin changes are evident
The nurse concludes that the participants of a community education class on prevention of osteoporosis are understanding the information when they identify which cause as a potential risk factor? Select all that apply. Excessive caffeine intake Large bone structure Smoking High-protein diet Alcoholism
Excessive caffeine intake Smoking High-protein diet Alcoholism
Which client reports would support a diagnosis of a torn ligament? Select all that apply. Redness Coolness Extreme pain Swelling Tingling
Extreme pain Swelling
The nurse is caring for a client who sustained a femur fracture 3 days before. The nurse notes that the client, who was previously oriented, now doesn't know where he is. The nurse suspects which condition? Osteomyelitis Reflex sympathetic dystrophy Compartment syndrome Fat embolism syndrome (FES)
Fat embolism syndrome (FES)
A child tripped while running in the yard and reports pain with weight bearing. The next morning, the foot is swollen, discolored, and painful to touch and pressure of walking. About which problem will the health care provider likely be talking to the parents and the child related to this injury? Fractured bone Strained ligament Bone cancer Nerve impingement
Fractured bone
Which statement is true regarding the development of juvenile idiopathic arthritis? Generalized stunted growth can occur. The condition will resolve in adulthood. Surgical intervention can stop the decline associated with the arthritis. A diagnosis will be made when two joints are affected.
Generalized stunted growth can occur.
When performing a musculoskeletal assessment on a young boy, the nurse notices that the boy has decreased space between the knees so that the medial malleoli cannot be brought together. The nurse documents this as: Genu valgum Internal femoral torsion Genu varum Bowleg
Genu valgum
Using Oestern and Tscherne's classification, how would a closed fracture that presented superficial abrasions and a mild fracture pattern be graded? Grade 2 Grade 0 Grade 3 Grade 1
Grade 1
When assessing a client diagnosed with Paget disease focused in the skull, the nurse should anticipate which findings? Select all that apply. Visual disturbances Headaches Intermitent tinnitus Hearing loss Vertigo
Headaches Intermitent tinnitus Hearing loss Vertigo
The nurse is performing an admission assessment to a rehabilitation unit. Which assessment tools should she utilize to determine an alert client's normal activities, perceived level of activity tolerance, or level of fatigue? Mini-Mental Examination Human Activity Profile Fatigue Severity Scale Ergometry
Human Activity Profile
When a nurse is caring for a client with gout, which medications will the nurse likely administer? Select all that apply. Simvastatin Cyclosporine Ibuprofen Colchicine Indomethacin
Ibuprofen Colchicine Indomethacin
The nurse is teaching a client diagnosed with osteomalacia about treatments to improve the condition. The best information for the nurse to provide would be: Decreased exposure to the natural UV radiation of the sun A bone marrow transplant Gaining weight of 5 to 10 pounds Increasing dietary consumption of vitamin D
Increasing dietary consumption of vitamin D
The nurse is explaining to a client that there are "cushions" in his back to absorb any jarring movement of the spine. Which anatomical structure is the nurse referring to? Intervertebral disks Spinal fluid Tendons Vertebral foramen
Intervertebral disks
A client has tendonitis. What will the nurse teach the client about this disorder? It is caused when tendons rupture It is caused by a bone fracture. It is caused by overuse. It is caused by ligaments rubbing on tendons.
It is caused by overuse.
Which statements are true regarding red bone marrow? Select all that apply. It is the site of blood cell formation. It is primarily present in the vertebrae, ribs, and sternum. It is the primary type of bone marrow found in infants. It is composed largely of adipose cells.
It is the site of blood cell formation. It is primarily present in the vertebrae, ribs, and sternum. It is the primary type of bone marrow found in infants.
Which statement is true concerning acute fatigue? It is not relieved by cessation of activity. It serves a protective function for the body. It has an insidious onset. It lasts longer than 1 month.
It serves a protective function for the body.
Which assessment findings will help the nurse to confirm the diagnosis of rheumatoid arthritis? Select all that apply. Joint stiffness Limited joint mobility Finger and hand pain Asymmetrical joint involvement Wrist pain
Joint stiffness Limited joint mobility Finger and hand pain Wrist pain
Which disease in children presents with an inflammatory myopathy primarily involving skin and muscle with a heliotrope rash around the eyes? Juvenile spondyloarthropathies Juvenile dermatomyositis Juvenile arthritis Systematic lupus erythematous
Juvenile dermatomyositis
The nurse is assessing a client for osteoarthritis (OS) of the knee. Which should the nurse consider to be expected findings? Select all that apply. Limitation of motion Shuffling gait Localized pain Crepitus Quadricep atrophy
Limitation of motion Localized pain Crepitus Quadricep atrophy
A client sustains a musculoskeletal injury of the left hip. In addition to pain, which manifestations would the nurse expect to accompany a dislocation? Select all that apply. Heat False motion Swelling Limited movement Shortened left leg Joint locking
Limited movement Shortened left leg
A client with a spinal cord injury has experienced contractures and destructive changes in the joints of the lower extremities. The nurse determines which of the following is the most likely cause? Hypermobility of joints Joint swelling Ligament and tendon damage Loss of proprioception and reflex control of the muscles
Loss of proprioception and reflex control of the muscles
The nurse is assessing a client with ankylosing spondylitis (AS). What does the nurse expect to find? Bruises on the lower extremities Lower back pain Facial butterfly rash Joint contractures
Lower backpain
What is the term used to refer to the failure of bone to heal before the process of bone repair stops? Nonunion Misunion Delayed union Malunion
Nonunion
While getting up out of bed for the first time after surgery, a client reports feeling dizzy and faint. Which condition is the client most likely experiencing? Increase in blood volume Anemia Orthostatic intolerance Virchow triad
Orthostatic intolerance
A client has developed increased resorption of bone with removal of mineral content. This is most likely the result of: Osteoblasts Osteoprogenitors Osteoclasts Osteocytes
Osteoclasts
Which statements are true regarding bone remodeling? Select all that apply. Remodeled bone resembles original, unbroken bone. There is no visual evidence that identifies a remodeled bone. Osteoclasts gradually remove dead bone. Mineralized bone is present along the lines of the injury. Spongy bone replaces compact bone around the fracture.
Osteoclasts gradually remove dead bone. Mineralized bone is present along the lines of the injury.
The nurse is caring for a child who presented to the emergency department with multiple fractures in various stages of healing all over the body. The nurse collaborates with the physician on care for a client with which potential condition? Developmental dysplasia of the hip Osteogenesis imperfecta Recessive trait disorder Rheumatoid arthritis
Osteogenesis imperfecta
Which manifestations are associated with metastatic bone cancer of the spine? Select all that apply. Pathologic fractures Vertebrae that are easily crumbled Localized bone pain that is worse at night Swelling at the affected site Pain resulting from nerve entrapment
Pathologic fractures Vertebrae that are easily crumbled Localized bone pain that is worse at night Pain resulting from nerve entrapment
Which diagnoses in a client's medical history increase the risk of osteonecrosis? Select all that apply. Rheumatoid arthritis Sickle cell disease Osteoarthritis Vasculitis Systemic lupus erythematosus
Rheumatoid arthritis Sickle cell disease Vasculitis Systemic lupus erythematosus
What are the criteria categories required for the diagnosis of early-onset rheumatoid arthritis (RA)? Select all that apply. Serology Joint involvement Existence of comorbid conditions Acute phase reactants Duration of symptoms
Serology Joint involvement Acute phase reactants Duration of symptoms
A client is experiencing an episode of gout. The nurse recognizes that the condition is a result of: Serum blood urea nitrogen (BUN) Serum calcium levels Serum uric acid levels Serum calcitonin levels
Serum uric acid levels
A 50-year-old male has been diagnosed with contiguous spread osteomyelitis of the right hip acetabulum. What would be an expected treatment for this condition? Surgical amputation of the affected area Short-term administration of antimicrobials and rest for the affected area Surgical arthroplasty and parenteral antimicrobial agents Elevate legs and treat with narcotic analgesics for the discomfort
Surgical arthroplasty and parenteral antimicrobial agents
Which assessment abnormalities will the nurse find in a client who has patellar subluxation? Select all that apply Increased mobility Swelling Stiffness Crepitus "Popping" sound
Swelling Stiffness Crepitus "Popping" sound
A client is diagnosed with a strained back. Which instructions should the nurse provide to this client? Select all that apply. Take ibuprofen for pain. Bend knees to pick up objects. Wear a back brace for 3 weeks. Use heat for muscle pain. Reduce activity for a few days.
Take ibuprofen for pain. Bend knees to pick up objects. Reduce activity for a few days.
What intervention will the nurse perform first for the client who has a new fracture of the leg? Administer antibiotics Teach the client about X-ray examination Prepare the client for surgery Teach the client to use crutches
Teach the client about X-ray examination
A client presents to the emergency department after suffering an injury while playing sports. The client is diagnosed with a sprain. Select the best explanation of the injury. Excessive stretch of a muscle Tear of a ligamentous structure Unusual muscle contraction Hyperextension of a muscle
Tear of a ligamentous structure
A client diagnosed with Paget disease asks the health care provider how the disease developed.
The best response would be: "It is thought to have a probable association with a viral infection: paramyxovirus."
The nurse is providing client education related to intra-articular corticosteroid injections. Which instruction should the nurse include? The client or a family member will be taught to administer the injections daily. There will be minimal discomfort because the injections are placed in the subcutaneous tissue. The injections will be given only 3 to 4 times per year because they can increase joint destruction. There will be immediate relief with one injection and daily running can be resumed.
The injections will be given only 3 to 4 times per year because they can increase joint destruction.
Which statements are true regarding the skeletal system? Select all that apply. The skeleton relies on adipose tissue for cushioning. The skeletal system includes both bone and cartilage tissue. Cartilage is prevalent in both prenatal and postnatal life. The skull is considered a part of the axial skeleton. There is a type of skeleton referred to as appendicular.
The skeletal system includes both bone and cartilage tissue. Cartilage is prevalent in both prenatal and postnatal life. The skull is considered a part of the axial skeleton. There is a type of skeleton referred to as appendicular.
The nurse suspects idiopathic scoliosis in a client based on which assessment finding? Loss of bone density confirmed with x-ray Reports of back pain in the teen years Uneven shoulders or iliac crest Late onset of first menarche
Uneven shoulders or iliac crest
A client with a history of osteoarthritis in his hip, which he refers to as "bad hip," is also complaining of knee pain. The physiologic principle behind this would include the fact that: there is more than likely a tear in the synovial membrane, which is impacting the amount of plasma diffusing between the vessels and the joint. synovial tissue has received an injury that is referring pain to the knee. if the hip is dislocated, then the knee is not staying in the correct alignment. all joints of an extremity are innervated by the same peripheral nerves as they travel down the limb.
all joints of an extremity are innervated by the same peripheral nerves as they travel down the limb.
The diagnosis of chronic fatigue syndrome (CFS) is made using both a holistic approach as well as: mental health screenings for depression and anxiety. focused physical and occupational therapies. elimination of possible physical causes. aggressive diagnostic testing.
elimination of possible physical causes.
Select the statement that best describes a synovial or diarthrodial joint. The joint: is connected to bone by hyaline cartilage. moves little or not at all. moves freely. is found only in the lower extremities.
moves freely.
When a nurse is assessing a client with osteoarthritis, which factor poses a risk for the disease?
obesitiy
The nurse is providing teaching for parents of a 2-week-old infant just diagnosed with clubfoot. The nurse includes that the first treatment option is: surgical relaxation of foot ligaments and tendons. percutaneous tendoachilles lengthening. full-time wearing of Denis Brown splint. serial manipulations and casting.
serial manipulations and casting.
