Deck 38: Degenerative Diseases of the Musculoskeletal System

Question 1

The nurse is discussing the various fluids of the musculoskeletal system with staff nurses. Which statement made by an attending nurse indicates understanding?
1)"Lubricin is a lubricating liquid present in a joint."
2)"Synovial fluid is a protein that acts as a lubricant for the bone surfaces of a joint."
3)"Chondrocytes synthesize proteoglycan fluid in the later stages of osteoarthritis."
4)"Edematous fluid makes the joint capsule less effective as a protector."

Answer 1

4

Question 2

A client with osteoporosis was prescribed teriparatide therapy. Which outcome indicates the therapeutic effect of the medication has been achieved?
1)Reduced pain
2)Fortification of the bone
3)Reduced inflammation
4)Strengthening of the bone

Answer 2

4

Question 3

A client is diagnosed with degenerative disc disease. Which form of physical therapy does the nurse anticipate the health-care provider will prescribe to reduce the movement of the spine and enhance the healing process?
1)Braces
2)Massage
3)Electrotherapies
4)Heat and cold packs

Answer 3

1

Question 4

The nurse is obtaining a health history from a female client who is 70 years of age. The client has experienced two bone fractures over the past 5 years, one from an auto accident and the other from a fall on ice. Which information most strongly supports a concern about osteoporosis?
1)Wears sunscreen and a hat when outdoors
2)Experienced a total hysterectomy at age 35
3)Limited walking because of osteoarthritis
4)Receives protein primarily from chicken and fish

Question 5

Which diagnostic test does the nurse expect the health-care provider to prescribe to confirm a diagnosis of osteoporosis?
1)Electromyography (EMG)
2)Computerized tomography (CT) scan
3)Magnetic resonance imaging (MRI) scan
4)Dual energy x-ray absorptiometry (DEXA) scan

Question 6

Which condition in a client is a cause of cauda equina syndrome?
1)Celiac disease
2)Paget's disease
3)Cushing's disease
4)End-stage renal disease

Question 7

The nurse observes that an older adult client has a hunched back. Which disorder does the nurse suspect?
1)Osteoporosis
2)Osteomalacia
3)Osteoarthritis
4)Spinal stenosis

Question 8

The nurse in a pediatric clinic identifies an infant with rickets. The mother, who is from a Middle Eastern culture, has been exclusively breastfeeding the infant since birth. Which most probable cause does the nurse recognize?
1)Incidence of rickets in breastfed infants is high.
2)The infant lacks sufficient calcium and vitamin D.
3)Cultural practices contribute to the diagnosis.
4)The mother has a history of being lactose intolerant.

Question 9

A nurse is caring for a client whose lumbar spinal nerve 4 (L4) is affected by degenerative disc disease (DDD). Which assessment finding does the nurse anticipate in the client?
1)Diminished patella reflex
2)Diminished Achilles reflex
3)Difficulty with dorsiflexion of the foot
4)Difficulty with plantarflexion of the foot

Question 10

The primary care provider recommends measuring the trabecular bone density in a client's spine. For which diagnostic test does the nurse prepare the client?
1)X-ray
2)Electromyography (EMG)
3)Magnetic resonance imaging (MRI) scan
4)Quantitative computerized tomography (QCT) scan

Question 11

A client who is middle-aged comes to a clinic and reports knee pain. The client states, "I don't understand. I walk to and from work every day and climb three flights of steps to my office." Besides age, the nurse's assessment reveals the client is slightly overweight, and the knees are warm to the touch and slightly edematous. Which contributing factor to the client's manifestation does the nurse suspect?
1)Accumulation of edematous fluid in the joint
2)Increased joint stress related to body weight
3)Pain from inflammation of the synovial membrane
4)Cartilage deterioration from excess weight bearing

Question 12

The nurse is reviewing degenerative disc disease (DDD) with a group of staff nurses. Which statement made by an attending nurse indicates understanding?
1)"DDD occurs only in the cervical region of the vertebral column."
2)"Age-related degenerative changes in the discs are the main causes of lower back pain."
3)"Males are more susceptible than females to lumbar DDD."
4)"Onset of lumbar DDD occurs most often between the ages of 30 and 50."

Question 13

After assessing a client with spinal stenosis, the health-care provider orders immediate decompression surgery. Which symptom in the client did the health-care provider likely observe?
1)Diminished bowel and bladder function
2)Severe lower back pain
3)Pain walking up and down stairs
4)Diminished Achilles reflex

Question 14

A nursing instructor is teaching a group of nursing students the causes of spinal nerve impingement. Which statement made by the student indicates the need for further teaching?
1)"Herniated discs may cause spinal nerve impingement."
2)"Disc thickening may cause spinal nerve impingement."
3)"Osteocyte formation may cause spinal nerve impingement."
4)"Compression of the disc may cause spinal nerve impingement."

Question 15

Which physiological process takes place more rapidly after an individual is 30 years of age?
1)Bone growth
2)Osteoblastic activity
3)Osteoclastic activity
4)Bone remodeling

Question 16

The nurse is providing care for a client with suspected rickets. For which diagnostic testing does the nurse prepare the client?
1)Electromyography (EMG)
2)Bone mineral density (BMD) examination
3)Multiple-view x-ray studies
4)Dual energy x-ray absorptiometry (DEXA)

Question 17

Which statement is true regarding rheumatoid arthritis and osteoarthritis?
1)Rheumatoid arthritis is an autoimmune disease.
2)Osteoarthritis is mainly treated with methotrexate.
3)Osteoarthritis is less common than rheumatoid arthritis.
4)Rheumatoid arthritis affects mainly the proximal and distal interphalangeal joints.

Question 18

The nurse is caring for a client whose bone mineral density is -2 based on a T-score value, which compares the client's bone mineral density to the mean for young adult women. Which condition does this score indicate?
1)Osteomalacia
2)Osteopenia
3)Osteoporosis
4)Severe osteoporosis

Question 19

The nurse is caring for a client with degenerative disc disease (DDD). Which outcome indicates effective chiropractic therapy?
1)The client's discs are realigned.
2)The client has diminished inflammation.
3)The client has decreased neuropathic pain.
4)The client has receding pain from sciatica.

Question 20

A client is diagnosed with osteomalacia and undergoes therapy to correct the vitamin D deficiency and normalize phosphate levels. Which outcome indicates the successful completion of therapy?
1)The client does not experience any cervical back pain.
2)The client is able to walk up and down stairs comfortably.
3)The client does not report any numbness in the lower extremities.
4)The client reports normal bowel and bladder function.

Question 21

Which disorders result from vitamin D deficiency? Select all that apply.
1)Rickets
2)Osteoporosis
3)Osteoarthritis
4)Osteomalacia
5)Spinal stenosis

Question 22

Which hormone indirectly helps in the formation of bone by stimulating muscle growth?
1)Testosterone
2)Calcitriol
3)Calcitonin
4)Parathyroid hormone

Question 23

Arrange the steps involved in maintaining the calcium balance in the body in the order they occur. (Enter the number of each step in the proper sequence; do not use commas or spaces.)
1) Release of calcium
2) Activation of osteoblasts
3) Activation of osteoclasts
4) Increased calcitonin level
5) Increased parathyroid hormone

Question 24

Which type of joint is the shoulder joint classified as? Select all that apply.
1)Synovial
2)Vertebral
3)Diarthrosis
4)Synarthrosis
5)Amphiarthrosis

Question 25

For which reason does the nurse instruct the parents of a young girl to reduce the use of sunblock and cover-ups with their child?
1)Overuse of sunblock and cover-ups will inhibit the production of estrogen.
2)Absorption of calcium by the gastrointestinal (GI) tract is inhibited by the overuse of sunblock and cover-ups.
3)The production of osteoblast cells is inhibited by the excessive use of sunblock and cover-ups.
4)The level of parathyroid hormone decreases with the excessive use of sunblock and cover-ups.
Other